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Affiliation(s)
- Ghady Haidar
- From the Department of Medicine, Division of Infectious Diseases, University of Pittsburgh School of Medicine, Pittsburgh
| | - Nina Singh
- From the Department of Medicine, Division of Infectious Diseases, University of Pittsburgh School of Medicine, Pittsburgh
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Georga S, Exadaktylou P, Petrou I, Katsampoukas D, Mpalaris V, Moralidis EI, Arvaniti K, Papastergiou C, Arsos G. Diagnostic Value of 18F-FDG-PET/CT in Patients with FUO. J Clin Med 2020; 9:jcm9072112. [PMID: 32635566 PMCID: PMC7408628 DOI: 10.3390/jcm9072112] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 06/24/2020] [Accepted: 07/01/2020] [Indexed: 12/14/2022] Open
Abstract
Conventional diagnostic imaging is often ineffective in revealing the underlying cause in a considerable proportion of patients with fever of unknown origin (FUO). The aim of this study was to assess the diagnostic value of fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG-PET/CT) in patients with FUO. We retrospectively reviewed 18F-FDG-PET/CT scans performed on 50 consecutive adult patients referred to our department for further investigation of classic FUO. Final diagnosis was based on histopathological and microbiological findings, clinical criteria, or clinical follow-up. Final diagnosis was established in 39/50 (78%) of the patients. The cause of FUO was infection in 20/50 (40%), noninfectious inflammatory diseases in 11/50 (22%), and malignancy in 8/50 (16%) patients. Fever remained unexplained in 11/50 (22%) patients. 18F-FDG-PET/CT scan substantially contributed to the diagnosis in 70% of the patients, either by identifying the underlying cause of FUO or by directing to the most appropriate site for biopsy. Sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) of 18F-FDG-PET/CT for active disease detection in patients with FUO were 94.7%, 50.0%, 84.0%, 85.7%, and 75.0%, respectively. In conclusion, whole-body 18F-FDG-PET/CT is a highly sensitive method for detection of the underlining cause of FUO or for correctly targeting suspicious lesions for further evaluation.
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Affiliation(s)
- Stamata Georga
- 3rd Department of Nuclear Medicine, Aristotle University of Thessaloniki Medical School, Papageorgiou General Hospital, 56403 Thessaloniki, Greece; (P.E.); (I.P.); (D.K.); (V.M.); (E.-I.M.); (G.A.)
- Correspondence: ; Tel.: +30-6944687881
| | - Paraskevi Exadaktylou
- 3rd Department of Nuclear Medicine, Aristotle University of Thessaloniki Medical School, Papageorgiou General Hospital, 56403 Thessaloniki, Greece; (P.E.); (I.P.); (D.K.); (V.M.); (E.-I.M.); (G.A.)
| | - Ioannis Petrou
- 3rd Department of Nuclear Medicine, Aristotle University of Thessaloniki Medical School, Papageorgiou General Hospital, 56403 Thessaloniki, Greece; (P.E.); (I.P.); (D.K.); (V.M.); (E.-I.M.); (G.A.)
| | - Dimitrios Katsampoukas
- 3rd Department of Nuclear Medicine, Aristotle University of Thessaloniki Medical School, Papageorgiou General Hospital, 56403 Thessaloniki, Greece; (P.E.); (I.P.); (D.K.); (V.M.); (E.-I.M.); (G.A.)
| | - Vasilios Mpalaris
- 3rd Department of Nuclear Medicine, Aristotle University of Thessaloniki Medical School, Papageorgiou General Hospital, 56403 Thessaloniki, Greece; (P.E.); (I.P.); (D.K.); (V.M.); (E.-I.M.); (G.A.)
| | - Efstratios-Iordanis Moralidis
- 3rd Department of Nuclear Medicine, Aristotle University of Thessaloniki Medical School, Papageorgiou General Hospital, 56403 Thessaloniki, Greece; (P.E.); (I.P.); (D.K.); (V.M.); (E.-I.M.); (G.A.)
| | - Kostoula Arvaniti
- ICU and Antimicrobial Stewardship Unit, Papageorgiou General Hospital, 56403 Thessaloniki, Greece;
| | | | - Georgios Arsos
- 3rd Department of Nuclear Medicine, Aristotle University of Thessaloniki Medical School, Papageorgiou General Hospital, 56403 Thessaloniki, Greece; (P.E.); (I.P.); (D.K.); (V.M.); (E.-I.M.); (G.A.)
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